Department of Public Health, University of Copenhagen, Copenhagen K, Denmark.
J Natl Cancer Inst. 2012 May 2;104(9):682-9. doi: 10.1093/jnci/djs176. Epub 2012 Apr 5.
Screening for disease in healthy people inevitably leads to some false-positive tests in disease-free individuals. Normally, women with false-positive screening tests for breast cancer are referred back to routine screening. However, the long-term outcome for women with false-positive tests is unknown.
We used data from a long-standing population-based screening mammography program in Copenhagen, Denmark, to determine the long-term risk of breast cancer in women with false-positive tests. The age-adjusted relative risk (RR) of breast cancer for women with a false-positive test compared with women with only negative tests was estimated with Poisson regression, adjusted for age, and stratified by screening round and technology period. All statistical tests were two-sided.
A total of 58 003 women, aged 50-69 years, were included in the analysis. Women with negative tests had an absolute cancer rate of 339/100 000 person-years at risk, whereas women with a false-positive test had an absolute rate of 583/100 000 person-years at risk. The adjusted relative risk of breast cancer after a false-positive test was 1.67 (95% confidence interval [CI] 1.45 to 1.88). The relative risk remained statistically significantly increased 6 or more years after the false-positive test, with point estimates varying between 1.58 and 2.30. When stratified by assessment technology phase and using equal follow-up time, the false-positive group from the mid 1990s had a statistically significantly higher risk of breast cancer (RR = 1.65, 95% CI = 1.22 to 2.24) than the group with negative tests, whereas the false-positive group from the early 2000s was not statistically significantly different from the group testing negative.
The implementation of new assessment technology coincided with a decrease in the size of excess risk of breast cancer for women with false-positive screening results. However, it may be beneficial to actively encourage women with false-positive tests to continue to attend regular screening.
在健康人群中进行疾病筛查不可避免地会导致一些无病个体的假阳性检测。通常，乳腺癌筛查假阳性的女性会被重新纳入常规筛查。然而，假阳性检测女性的长期结局尚不清楚。
我们使用丹麦哥本哈根一项长期基于人群的筛查乳房 X 线摄影计划的数据，确定了假阳性检测女性的乳腺癌长期风险。使用泊松回归估计了假阳性检测女性与仅阴性检测女性相比的乳腺癌年龄调整相对风险（RR），并根据筛查轮次和技术时期进行了分层调整。所有统计检验均为双侧检验。
共纳入 58003 名年龄在 50-69 岁的女性进行分析。阴性检测女性的绝对癌症发生率为每 100000 人年 339 例，而假阳性检测女性的绝对癌症发生率为每 100000 人年 583 例。假阳性检测后乳腺癌的调整相对风险为 1.67（95%置信区间 [CI] 1.45 至 1.88）。假阳性检测 6 年或更长时间后，相对风险仍显著增加，点估计值在 1.58 至 2.30 之间。当按评估技术阶段分层并使用相等的随访时间时，20 世纪 90 年代中期的假阳性组乳腺癌风险显著高于阴性检测组（RR=1.65，95%CI 1.22 至 2.24），而 21 世纪初的假阳性组与阴性检测组无显著差异。
新评估技术的实施与假阳性筛查结果女性乳腺癌超额风险的降低有关。然而，积极鼓励假阳性检测的女性继续参加常规筛查可能是有益的。
